At 6-month follow-up, the patient has recovered short-distance going for walks ability (12 m) with the support of going for walks aids. The clinical course of patient #3 was complicated from the occurrence of a deep venous thrombosis affecting the remaining leg about 2 months after the onset of neurological symptoms. polyradiculoneuropathy (AIDP) in two individuals and an acute engine and sensory axonal neuropathy (AMSAN) in Rabbit polyclonal to PLD4 the third patient. At follow-up, the electrophysiological features improved in one subject with AIDP and were stable in the remaining two instances. The functional assessment after neurorehabilitation showed global recovery and full independence in walking and in activities of daily life in one individual and slight improvement in the additional two instances. Of the two subjects with myelitis, the baseline electrophysiological exam showed a prolonged central engine conduction time, which returned to normal in one patient, whereas it improved but remained pathological in the additional patient at follow-up. The neurorehabilitation led to a substantial practical improvement in both subjects. Conversation and Conclusions: This is the 1st study to describe medical and electrophysiological elements along with medium-term end result in individuals with COVID-19-related neurological manifestations who underwent an intensive rehabilitation system. The functional end result following neurorehabilitation in individuals with PINS related to SARS-CoV-2 illness is variable. In our small case series, subjects with polyradiculoneuropathy experienced a poorer recovery compared to individuals with myelitis. The medical program PPQ-102 mainly paralleled the follow-up electrophysiological findings. 2nd examination: albumin-cytological dissociationNormal, SARS-CoV-2 RT-qPCR negativeMarked pleocytosis with neutrophil prevalence, hyperproteinorrachia and oligoclonal bands, SARS-CoV-2 RT-qPCR negativeNormal (polyclonal distribution of immunoglobulins), SARS-CoV-2 RT-qPCR negativeBrain MRI findingsNot performedChronic cerebrovascular diseaseNot performedNormalNormalSpinal wire MRI findingsCNo indications of myelitis nor thickening or contrast enhancement of nerve rootsNo indications of myelitis nor thickening or contrast enhancement of nerve rootsMultiple small T2-hyperintense cervical and thoracic lesions, mostly influencing the lateral and posterior columnsT2-hyperintensity in the thoracic spinal cord level mainly influencing the T3 and T8-T10 myelomeresNeurological symptoms at baselineImpaired walking and sensory loss at the lower limbs which rapidly developed to tetraparesis with acute respiratory failureWalking impairment and diffuse paresthesia, gradually evolving inside a tetraparesis with sensory deficit in the four limbsProgressive sensory-motor deficit in the four limbs (sensory symptoms common on engine impairment)Acute urinary retention, rapidly followed by total engine and sensory impairment PPQ-102 in the lower limbsHyposthenia in both legs, paresthesia and numbness with top level in the breast line and sensation of incomplete bladder emptyingAcute Treatments of the neurological syndromeIVIG, 1 cycle of 3 days (0.4 g/die)IVIG, 2 cycles of 5 days each (0.4 g/die) within the 1st monthIVIG, 1 cycle of 5 days (0.4 g/die)IVIG, 1 cycle of 5 days (0.4 g/pass away)2 cycles of IV methylprednisolone 1 g/day time (each of 7 days) having a 3-month intervalChronic treatments of the neurological syndromeNonePlasma exchange cycles, 6 instances over 14 daysNoneNoneLow dose of oral prednisone having a tapering plan over 2 monthsDuration of rehabilitation treatment including physiotherapy and occupational therapy, days1201793612872Clinical outcomeAutonomy recovery; persistence of slight distal weakness at lower limbsAutonomy in self transferring, ability to walk with aids and bilateral supportAutonomy recovery; walking with right ankle-foot orthosisAutonomy recovery; normal walking but with early fatigueAutonomy recovery; persistence of distal weakness at lower limbs and gait ataxia Open in a separate windowpane concomitant illness. This patient required a total stay of 56 days in the ICU and started an intensive rehabilitation program only 2 months after the onset of symptoms. Patient #3 presented severe worsening of the respiratory muscular overall performance as well: at first, the possibility of a plasma exchange was evaluated, but in order to avoid a possible worsening of the COVID-19 contamination, we chose to perform a second IVIG cycle. The procedure halted clinical deterioration, and the patient was therefore transferred to the neurorehabilitation PPQ-102 unit. Patients #4 and #5 presented with progressive sensory and motor deficits in the lower limbs associated with bladder dysfunction with urinary retention (Furniture 1, ?,2).2). As mentioned above, no sign of SARS-CoV-2 replication was observed in the CSF, while both patients presented altered MRI signals proving an inflammatory spinal cord involvement. Findings from electroneurography (ENG) and EMG assessment of the four limbs were within normal ranges. Both subjects tested unfavorable for antibodies against AQP4, MOG, GQ1b, or GD1b. MEP investigation in individual #4 revealed an impaired corticospinal conduction deriving from the lower limbs, with asymmetric involvement (predominant around the left side); MEP findings in patient #5 were consistent with a diffuse impairment of the.